Read more about treating an ectopic pregnancy. Losing a pregnancy can be devastating, and many women feel the same sense of grief as if they had lost a family member or partner. It's not uncommon for these feelings to last several months, although they usually improve with time.
Make sure you give yourself and your partner time to grieve. If you or your partner are struggling to come to terms with your loss, you may benefit from professional support or counselling. Speak to your GP about this. Read more about dealing with loss and find bereavement support services in your area.
You may want to try for another baby when you and your partner feel physically and emotionally ready. You'll probably be advised to wait until you've had at least 2 periods after treatment before trying again to allow yourself to recover. If you were treated with methotrexate, it's usually recommended that you wait at least 3 months because the medicine could harm your baby if you become pregnant during this time.
Most women who have had an ectopic pregnancy will be able to get pregnant again, even if they've had a fallopian tube removed. Occasionally, it may be necessary to use fertility treatment such as IVF. This content does not have an Arabic version.
Overview Ectopic pregnancy Open pop-up dialog box Close. Ectopic pregnancy In a healthy pregnancy, the fertilized egg attaches itself to the lining of the uterus. Request an Appointment at Mayo Clinic. Share on: Facebook Twitter.
Show references Cunningham FG, et al. Implantation and placental development. In: Williams Obstetrics. McGraw-Hill Education; Accessed Dec. Tulandi T. Ectopic pregnancy: Epidemiology, risk factors, and anatomic sites. The pregnancy can grow out of the uterus or into the cervix, which can lead to massive internal or vaginal bleeding.
In some cases, the fetus may be able to survive until birth, but with the risk of significant maternal bleeding and removal of the womb, known as hysterectomy, at delivery.
Intramural pregnancy: This is a difficult-to-diagnose pregnancy that implants outside of the womb cavity, but within its muscular wall. It may occur if the uterus is scarred from surgery or if a condition called adenomyosis is present, in which the inner lining of the uterus breaks through the muscle wall of the uterus.
Abdominal pregnancy: Pregnancies in the abdomen are thought to start as tubal pregnancies, before separating from the wall of the fallopian tube and passing into the abdominal cavity, where they reattach.
These can take many weeks before showing symptoms. Heterotopic pregnancy: This term describes the co-existence of an intrauterine pregnancy and an ectopic pregnancy. The intrauterine twin is able to survive until birth in about one third of cases, after surgical treatment of the ectopic pregnancy. A person may be referred to a gynecology clinic for further assessment.
Good to know: Diagnosis of ectopic pregnancy can be delayed because the symptoms are often similar to other, more well-known conditions, such as gastroenteritis, appendicitis or miscarriage. For more information, see the resource about signs of miscarriage.
Ultrasound is an imaging technique which uses soundwaves to create an image of the developing pregnancy. It is a painless and non-invasive procedure which can be performed in two different ways: [8].
In diagnosing an ectopic pregnancy, doctors will look for where the pregnancy is located in the ultrasound images. Ultrasound indicators for ectopic pregnancy include: [9]. No pregnancy in the uterus, or a gestation sac in the uterus missing an embryo: This is a pregnancy of unknown location PUL.
This is a label given until the pregnancy location can be found, and a diagnosis can be given. Many of these will not be ectopic and will not need treatment. No pregnancy in the uterus and a possible mass in the area of a fallopian tube: This would likely lead to diagnosis of a possible ectopic pregnancy. Human chorionic gonadotropin hCG is a hormone produced by the placenta, an organ that develops in the womb during pregnancy. A beta hCG blood test can detect hCG in the blood approximately 11 days after conception and establish the precise amount of hCG present.
This might be used if a person has been pregnant for six weeks, but an ultrasound scan does not show a developing pregnancy in the uterus. The test may be repeated at intervals to measure changes in hCG levels. Possible indicators for ectopic pregnancy from a beta hCG blood test include: [11]. In a healthy pregnancy, hCG levels in the blood double about every two to four days throughout the first trimester, reaching their peak after weeks and then decreasing before plateauing during the second trimester.
Rarely, laparoscopy, a type of keyhole surgery, is used to confirm the diagnosis, if hCG and ultrasound results are ambiguous.
Under general anesthetic, a laparoscope, a narrow instrument with a camera and light on the end, is inserted through a small cut, usually into the belly button, to look at the pelvis.
If an ectopic pregnancy is found, treatment to remove it may take place during the same operation. An ectopic pregnancy can be life threatening if left untreated and normally requires medical or surgical intervention to remove it. However, in some cases, when it is diagnosed early, ectopic pregnancy may be monitored to see if it will resolve on its own. Treatment options depend on: [12]. Also known as conservative or wait-and-see management, expectant management involves waiting to see if the ectopic pregnancy tissue passes out of the cervix on its own, instead of undergoing immediate treatment.
Expectant management is only offered as an option in some cases of very early diagnosis. Candidates for expectant management of ectopic pregnancy should: [13]. The approach involves close monitoring by medical professionals through repeated blood tests to check that hCG levels are dropping. It can take a few weeks or sometimes months for this to happen. About half of ectopic pregnancies may resolve on their own where there is a drop in hCG levels.
If a person develops new symptoms, another ultrasound scan may be done, and treatment options will be reassessed. Medical or surgical intervention may be required if it does not complete as planned. Sometimes, an ectopic pregnancy may be treated with a medication called methotrexate.
This stops the growth of the embryo and typically allows surgery to be avoided. Medical management may be suitable if a diagnosis has been made very early. Treatment with methotrexate is an especially attractive option if the pregnancy is located in the cervix or ovary or in the interstitial or the cornual portion of the tube. Surgical treatment in these cases is often associated with an increased risk of hemorrhage. Methotrexate is administered as an injection, usually a single shot into the buttock muscle.
After the injection, there may be an overnight stay in hospital, and regular follow-up visits will be needed for a few weeks to monitor hCG levels until they return to normal. Some people will need a second injection of methotrexate.
This is known as a rupture. Ruptures are very serious, and surgery to repair the fallopian tube needs to be carried out as soon as possible. Page last reviewed: 27 November Next review due: 27 November Main symptoms You may have an ectopic pregnancy if you miss a period, have a positive pregnancy test , and have other signs of pregnancy , in addition to any of the symptoms listed below.
Vaginal bleeding Vaginal bleeding tends to be a bit different to your regular period. Tummy pain You may experience tummy pain , typically low down on 1 side. But you should get medical advice if you have it and think you might be pregnant.
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